﻿<%@ Page Language="C#" MasterPageFile="~/personal-accident/proposalforms/PersonalAccidentProposalMasterPage.master"
    Async="true" AutoEventWireup="true" CodeFile="eq_proposal_form.aspx.cs" Inherits="personal_accident_proposalforms_eq_proposal_form" %>

<%@ Register Src="~/controls/usrNoJS.ascx" TagName="usrNoJS" TagPrefix="ucNoJS" %>
<%@ Register Src="~/controls/usrPhoneNo.ascx" TagName="usrPhoneNo" TagPrefix="uc1" %>
<%@ Register Src="~/controls/usrDate.ascx" TagName="usrDate" TagPrefix="uc2" %>
<%@ Register Src="~/controls/usrIdNumber.ascx" TagName="usrIdNumber" TagPrefix="uc3" %>
<%@ Register Src="~/controls/usrNationality.ascx" TagName="usrNationality" TagPrefix="uc4" %>
<%@ Register Src="~/controls/usrSalutation.ascx" TagName="usrSalutation" TagPrefix="uc5" %>
<%@ Register Src="~/controls/usrMaritalStatus.ascx" TagName="usrMaritalStatus" TagPrefix="uc6" %>
<%@ Register Src="~/controls/usrGender.ascx" TagName="usrGender" TagPrefix="uc7" %>
<%@ Register Src="~/controls/usrRelationship.ascx" TagName="usrRelationship" TagPrefix="uc9" %>
<asp:Content ID="Content1" ContentPlaceHolderID="ContentPlaceHolder1" runat="Server">

    <script src="../../includes/cx_jquery_post_code.js" type="text/javascript"></script>

    <script src="../../controls/CE_Date.js" type="text/javascript"></script>

    <script src="../../controls/IdNumber.js" type="text/javascript"></script>

    <asp:ScriptManager ID="ScriptManager1" runat="server">
    </asp:ScriptManager>
    <div id="container">
        <div id="nav_top">
            <div class="left pad_8yr">
                <a href="/personal-accident/results.aspx" onclick="return confirm('Are you sure to go back?');">
                    <img src="/images/forms_proposal/button/back.png" alt="Back" /></a></div>
            <div class="right pad_8yr">
                <img src="/images/forms_proposal/nav/logo_comparexpress.png" alt="CompareXpress" /></div>
        </div>
        <ucNoJS:usrNoJS ID="usrNoJS1" runat="server" />
        <!-- #Include file="../../includes/body_loader.inc" -->

        <script type="text/javascript">
            IncreaseProgress(5);
        </script>

        <div id="divContent" style="display: none">
            <div id="contentBody">
                <div id="header">
                    <div class="seperator">
                    </div>
                    <div class="right" style="width: 240px">
                        <div class="quotesum_button">
                            <img src="/images/forms_proposal/button/quotesum.png" width="240" height="73" alt="Quote Summary" /></div>
                    </div>
                    <h1>
                        Online Personal Accident Proposal Form -
                        <asp:Label ID="lblProvider" runat="server"></asp:Label></h1>
                    <div class="seperator">
                    </div>
                    <div class="quotesum">
                        <div class="top">
                        </div>
                        <div id="divQuoteSummery" class="body pad_15x">
                            <!-- QUOTE SUMMARY | Start -->
                            <div class="w21per left pad_25xr">
                                <h1>
                                    <asp:Label ID="lblPlanHead" runat="server" Text="Plan Name : "></asp:Label></h1>
                                <p>
                                    <asp:Label ID="lblPlanName" runat="server"></asp:Label></p>
                            </div>
                            <div class="w21per left pad_25xr">
                                <h1>
                                    <asp:Label ID="lblPolicyHead" runat="server" Text="Policy Type : "></asp:Label></h1>
                                <p>
                                    <asp:Label ID="lblPolicyType" runat="server"></asp:Label></p>
                            </div>
                            <div class="w21per left pad_25xr">
                                <h1>
                                    <asp:Label ID="lblPremiumHead" runat="server" Text="Annual Premium  : $"></asp:Label></h1>
                                <p>
                                    <asp:Label ID="lblAnnualPremium" runat="server"></asp:Label>
                                    (+ GST 7%)</p>
                            </div>
                            <!-- QUOTE SUMMARY | End   -->
                        </div>
                        <div class="bottom">
                        </div>
                    </div>
                </div>
                <div class="seperator">
                </div>
                <div id="body">
                </div>
                <div id="divValidationSummary">
                    <asp:ValidationSummary ID="vsproposal" runat="server" CssClass="errorSummary" ValidationGroup="proposal"
                        HeaderText="Oops please complete the form" />
                </div>
                <div style="display: none">
                    <asp:TextBox ID="txtPolicyType" runat="server"></asp:TextBox>
                    <asp:Label ID="lblCompanyId" runat="server"></asp:Label>
                </div>
                <div class="form">
                    <div class="top">
                        <div class="left">
                            <div class="pad_10t pad_35xl white">
                                Online Personal Accident Proposal Form</div>
                        </div>
                        <div class="right">
                        </div>
                    </div>
                    <div class="body">
                        <div class="inner">
                            <div class="pad_20x10y">
                                <div class="norm">
                                    <div class="top_t">
                                    </div>
                                    <div class="body">
                                        <div class="pad_15x">
                                            <p>
                                                <b>Important Notice:</b><br />
                                                1. Pursuant to Section 25(5) of the Insurance Act (Chap. 142) and any replacement
                                                thereof, you are to disclose in this Proposal Form all the facts, which you know
                                                or ought to know, otherwise the Policy issued hereunder may be void.<br />
                                                2. All questions in this Proposal Form must be answered before this proposal can
                                                be considered. Any question not answered will be taken as answered in the negative.
                                                The liability of the Company does not commence on respect of this proposal until
                                                acceptance has been communicated by the Company to the Proposer or his Agent or
                                                Broker
                                                <br />
                                                3. If the space provided is insufficient, please write the details on a separate
                                                sheet of paper and attach it to this Proposal Form.
                                            </p>
                                        </div>
                                    </div>
                                    <div class="bottom">
                                    </div>
                                </div>
                                <div class="seperator">
                                </div>
                                <div class="hilite">
                                    <div class="top">
                                    </div>
                                    <div class="body_in pad_15x">
                                        <h1>
                                            Proposer's Information</h1>
                                        <div class="seperator">
                                        </div>
                                        <div class="w43per left">
                                            <div id="divName">
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Name:</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtName" MaxLength="50" runat="server" size="25"></asp:TextBox>&nbsp;
                                                    <asp:RequiredFieldValidator ID="rfvName" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtName"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revName" runat="server" ControlToValidate="txtName"
                                                        ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                        Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                </div>
                                            </div>
                                            <div class="h10">
                                            </div>
                                            <div>
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Gender:</div>
                                                <div class="left">
                                                    <uc7:usrGender ID="ddlGender" ValidationGroup="proposal" IsEnabled="true" ErrorMessage=""
                                                        runat="server" />
                                                </div>
                                            </div>
                                            <div class="h10">
                                            </div>
                                            <div id="divNRICNo">
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> NRIC Number:</div>
                                                <div class="left">
                                                    <uc3:usrIdNumber ID="ddlIdNumber" runat="server" ValidationGroup="proposal" />
                                                </div>
                                            </div>
                                            <div class="h10">
                                            </div>
                                            <div id="divNationality">
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Nationality:</div>
                                                <div class="left">
                                                    <uc4:usrNationality ID="ddlNationality" runat="server" ErrorMessage="" ValidationGroup="proposal" />
                                                </div>
                                            </div>
                                            <div class="h10">
                                            </div>
                                            <div id="divAEmail">
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> E-mail:</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtEmail" MaxLength="50" runat="server" size="25"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvEmail" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtEmail" Display="Dynamic"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revEmail" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtEmail" ValidationExpression="\w+([-+.']\w+)*@\w+([-.]\w+)*\.\w+([-.]\w+)*"></asp:RegularExpressionValidator>
                                                </div>
                                            </div>
                                        </div>
                                        <div class="w56per left">
                                            <asp:UpdatePanel ID="UpdatePanel1" runat="server">
                                                <ContentTemplate>
                                                    <div id="divPostCode">
                                                        <div class="w180 left align_right pad_6t pad_7xr">
                                                            <span class="red">*</span> Postcode:
                                                        </div>
                                                        <asp:TextBox ID="txtPostCode" size="8" onkeypress="restrictToNumbers(event)" AutoPostBack="true"
                                                            OnTextChanged="txtPostCode_TextChanged" runat="server" MaxLength="6" Width="80px"></asp:TextBox>
                                                        <asp:ImageButton ID="ibtPostCode" runat="server" CssClass="button" align="absmiddle"
                                                            OnClick="ibtPostCode_Click" Width="108" ValidationGroup="PostCode" AlternateText="Get Address"
                                                            ImageUrl="~/images/forms_proposal/button/getaddress.png" />
                                                        <asp:UpdateProgress runat="server" ID="uplUpProgress" DisplayAfter="500">
                                                            <ProgressTemplate>
                                                                <span style="position: absolute; text-align: right; width: 390px;">
                                                                    <img src="../../images/loading7.gif" id="ldPostCode" alt="loading" />
                                                                </span>
                                                            </ProgressTemplate>
                                                        </asp:UpdateProgress>
                                                        <asp:RequiredFieldValidator ID="rfvPCode" runat="server" CssClass="validationErrorControl"
                                                            Display="Dynamic" ErrorMessage="" ValidationGroup="PostCode" ControlToValidate="txtPostCode"></asp:RequiredFieldValidator>
                                                        <asp:RegularExpressionValidator ID="revPCode" runat="server" CssClass="validationErrorControl"
                                                            Display="Dynamic" ErrorMessage="" ValidationGroup="PostCode" ValidationExpression="[0-9]{6}"
                                                            ControlToValidate="txtPostCode"></asp:RegularExpressionValidator>
                                                        <asp:RequiredFieldValidator ID="rfvPostCode" runat="server" CssClass="validationErrorControl"
                                                            Display="Dynamic" ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtPostCode"></asp:RequiredFieldValidator>
                                                        <asp:RegularExpressionValidator ID="revPostCode" runat="server" CssClass="validationErrorControl"
                                                            Display="Dynamic" ErrorMessage="" ValidationGroup="proposal" ValidationExpression="[0-9]{6}"
                                                            ControlToValidate="txtPostCode"></asp:RegularExpressionValidator>
                                                    </div>
                                                    <div runat="server" visible="false" id="divAddressList">
                                                        <div class="h10">
                                                        </div>
                                                        <div class="w180 left align_right pad_6t pad_7xr">
                                                            Please choose your address
                                                        </div>
                                                        <asp:DropDownList ID="ddlAddressList" AutoPostBack="true" Width="320px" runat="server"
                                                            OnSelectedIndexChanged="ddlAddressList_SelectedIndexChanged">
                                                        </asp:DropDownList>
                                                    </div>
                                                </ContentTemplate>
                                            </asp:UpdatePanel>
                                            <div class="h10">
                                            </div>
                                            <div id="divUnitNo">
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Unit Number:
                                                </div>
                                                <asp:TextBox ID="txtUnit1" MaxLength="10" runat="server" size="8"></asp:TextBox>-
                                                <asp:RequiredFieldValidator ID="rfvUnit1" runat="server" CssClass="validationErrorControl"
                                                    ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtUnit1"></asp:RequiredFieldValidator>
                                                <asp:TextBox ID="txtUnit2" MaxLength="10" runat="server" size="8"></asp:TextBox>
                                                <asp:RequiredFieldValidator ID="rfvUnit2" runat="server" CssClass="validationErrorControl"
                                                    ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtUnit2"></asp:RequiredFieldValidator>
                                            </div>
                                            <div class="h10">
                                            </div>
                                            <asp:UpdatePanel ID="UpdatePanel2" runat="server">
                                                <ContentTemplate>
                                                    <div id="divPCAddress">
                                                        <div class="w180 left align_right pad_6t pad_7xr">
                                                            <span class="red">*</span> Address:
                                                        </div>
                                                        <span id="divAddress"></span>
                                                        <asp:TextBox ID="txtAddress" runat="server" TextMode="MultiLine" MaxLength="120"
                                                            Width="200px"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvAddress" runat="server" CssClass="validationErrorControl"
                                                            ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtAddress"></asp:RequiredFieldValidator>
                                                    </div>
                                                </ContentTemplate>
                                            </asp:UpdatePanel>
                                            <div class="h10">
                                            </div>
                                        </div>
                                        <div class="clear">
                                        </div>
                                        <div class="h10">
                                        </div>
                                        <div style="border: 1px solid #ccc; width: 912px; background: #d2d2d2;">
                                            <div class="h10">
                                            </div>
                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                Contact Info:</div>
                                            <div id="divMobileNo" class="w190 note left">
                                                <span class="red">*</span> Mobile Number<br />
                                                <uc1:usrPhoneNo ID="txtMobileNo" IsEnabled="true" IsRequired="true" PhoneNoRequireErrorMessage="Require mobile number."
                                                    PhoneNoErrorMessage="Mobile phone number should 8 digits." PhoneNoValidErrorMessage="Invalid mobile phone number."
                                                    runat="server" ValidationGroup="proposal" />
                                            </div>
                                            <div id="divOfficePhoneNo" class="w190 note left">
                                                Home Number<br />
                                                <uc1:usrPhoneNo ID="txtHomePhoneNo" runat="server" ValidationGroup="proposal" IsRequired="False" />
                                            </div>
                                            <div id="div1" class="w190 note left">
                                                Office Number<br />
                                                <uc1:usrPhoneNo ID="txtOfficePhoneNo" runat="server" ValidationGroup="proposal" IsRequired="False" />
                                            </div>
                                            <div class="h10">
                                            </div>
                                        </div>
                                        <div style="display: none">
                                            <asp:TextBox ID="txtIsCover" runat="server"></asp:TextBox></div>
                                        <div style="display: none">
                                            <asp:TextBox ID="txtCHCount" runat="server"></asp:TextBox></div>
                                    </div>
                                    <div class="bottom">
                                    </div>
                                </div>
                                <div class="seperator">
                                </div>

                                <script type="text/javascript">
                                    IncreaseProgress(20);
                                </script>

                                <asp:Panel ID="pnlSpouse" runat="server" Width="100%">
                                    <div class="hilite" id="divSpouse">
                                        <div class="top">
                                        </div>
                                        <div class="body_in pad_15x">
                                            <h1>
                                                Spouse's Particulars</h1>
                                            <div class="seperator">
                                            </div>
                                            <div class="w43per left">
                                                <div id="divSpouseName">
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span>Name:</div>
                                                    <div class="left">
                                                        <asp:TextBox ID="txtSpouseName" runat="server" MaxLength="50" size="25"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvSpouseName" runat="server" CssClass="validationErrorControl"
                                                            ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtSpouseName"></asp:RequiredFieldValidator>
                                                        <asp:RegularExpressionValidator ID="revSpouseName" runat="server" ControlToValidate="txtSpouseName"
                                                            ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                            Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                    </div>
                                                </div>
                                                <div class="h10">
                                                </div>
                                                <div id="divSpouseNRICNo">
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span>NRIC Number:</div>
                                                    <div class="left">
                                                        <uc3:usrIdNumber ID="ddlSpouseIdNumber" runat="server" ValidationGroup="proposal" />
                                                    </div>
                                                </div>
                                            </div>
                                            <div class="w56per left">
                                                <div id="divSpouseGender">
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Gender:</div>
                                                    <div class="left">
                                                        <uc7:usrGender ID="ddlSpouseGender" ValidationGroup="proposal" ErrorMessage="" runat="server" />
                                                    </div>
                                                </div>
                                            </div>
                                            <div class="clear">
                                            </div>
                                        </div>
                                        <div class="bottom">
                                        </div>
                                    </div>
                                    <div class="seperator">
                                    </div>
                                </asp:Panel>
                                <asp:Panel ID="pnlChildParticulars" runat="server" Width="100%">
                                    <div class="hilite" id="divChilds">
                                        <div class="top">
                                        </div>
                                        <div class="body_in pad_15x">
                                            <h1>
                                                Child's Particulars</h1>
                                            <asp:Panel ID="pnlChild1" runat="server" Width="100%">
                                                <div class="seperator">
                                                </div>
                                                <div>
                                                    <h3>
                                                        Child 1</h3>
                                                    <div class="h10">
                                                    </div>
                                                    <div class="w43per left">
                                                        <div id="divChildName1">
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Name:</div>
                                                            <div class="left pad_6t">
                                                                <asp:TextBox ID="txtChildName1" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                                <asp:RequiredFieldValidator ID="rfvChildName1" runat="server" CssClass="validationErrorControl"
                                                                    ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtChildName1"></asp:RequiredFieldValidator>
                                                                <asp:RegularExpressionValidator ID="revChildName1" runat="server" ControlToValidate="txtChildName1"
                                                                    ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                                    Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                            </div>
                                                        </div>
                                                        <div class="h10">
                                                        </div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Date of Birth:</div>
                                                            <div class="left">
                                                                <uc2:usrDate ID="ddlChildDOB1" ValidationGroup="proposal" runat="server"></uc2:usrDate>
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="w56per left">
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> NRIC Number:</div>
                                                            <div class="left">
                                                                <uc3:usrIdNumber ID="ddlChildIdNumber1" runat="server" ValidationGroup="proposal" />
                                                            </div>
                                                        </div>
                                                        <div class="h10">
                                                        </div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Gender:</div>
                                                            <div class="left">
                                                                <uc7:usrGender ID="ddlChildGender1" ValidationGroup="proposal" IsEnabled="true" ErrorMessage=""
                                                                    runat="server" />
                                                            </div>
                                                        </div>
                                                        <div class="clear">
                                                        </div>
                                                    </div>
                                                </div>
                                            </asp:Panel>
                                            <asp:Panel ID="pnlChild2" runat="server" Width="100%">
                                                <div class="seperator">
                                                </div>
                                                <div>
                                                    <h3>
                                                        Child 2</h3>
                                                    <div class="h10">
                                                    </div>
                                                    <div class="w43per left">
                                                        <div id="divChildName2">
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Name:</div>
                                                            <div class="left pad_6t">
                                                                <asp:TextBox ID="txtChildName2" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                                <asp:RequiredFieldValidator ID="rfvChildName2" runat="server" CssClass="validationErrorControl"
                                                                    ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtChildName2"></asp:RequiredFieldValidator>
                                                                <asp:RegularExpressionValidator ID="revChildName2" runat="server" ControlToValidate="txtChildName2"
                                                                    ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                                    Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                            </div>
                                                        </div>
                                                        <div class="h10">
                                                        </div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Date of Birth:</div>
                                                            <div class="left">
                                                                <uc2:usrDate ID="ddlChildDOB2" ValidationGroup="proposal" runat="server"></uc2:usrDate>
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="w56per left">
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> NRIC Number:</div>
                                                            <div class="left">
                                                                <uc3:usrIdNumber ID="ddlChildIdNumber2" runat="server" ValidationGroup="proposal" />
                                                            </div>
                                                        </div>
                                                        <div class="h10">
                                                        </div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Gender:</div>
                                                            <div class="left">
                                                                <uc7:usrGender ID="ddlChildGender2" ValidationGroup="proposal" IsEnabled="true" ErrorMessage=""
                                                                    runat="server" />
                                                            </div>
                                                        </div>
                                                        <div class="clear">
                                                        </div>
                                                    </div>
                                                </div>
                                            </asp:Panel>
                                            <asp:Panel ID="pnlChild3" runat="server" Width="100%">
                                                <div class="seperator">
                                                </div>
                                                <div>
                                                    <h3>
                                                        Child 3</h3>
                                                    <div class="h10">
                                                    </div>
                                                    <div class="w43per left">
                                                        <div id="divChildName3">
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Name:</div>
                                                            <div class="left pad_6t">
                                                                <asp:TextBox ID="txtChildName3" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                                <asp:RequiredFieldValidator ID="rfvChildName3" runat="server" CssClass="validationErrorControl"
                                                                    ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtChildName3"></asp:RequiredFieldValidator>
                                                                <asp:RegularExpressionValidator ID="revChildName3" runat="server" ControlToValidate="txtChildName3"
                                                                    ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                                    Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                            </div>
                                                        </div>
                                                        <div class="h10">
                                                        </div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Date of Birth:</div>
                                                            <div class="left">
                                                                <uc2:usrDate ID="ddlChildDOB3" ValidationGroup="proposal" runat="server"></uc2:usrDate>
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="w56per left">
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> NRIC Number:</div>
                                                            <div class="left">
                                                                <uc3:usrIdNumber ID="ddlChildIdNumber3" runat="server" ValidationGroup="proposal" />
                                                            </div>
                                                        </div>
                                                        <div class="h10">
                                                        </div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Gender:</div>
                                                            <div class="left">
                                                                <uc7:usrGender ID="ddlChildGender3" ValidationGroup="proposal" IsEnabled="true" ErrorMessage=""
                                                                    runat="server" />
                                                            </div>
                                                        </div>
                                                        <div class="clear">
                                                        </div>
                                                    </div>
                                                </div>
                                            </asp:Panel>
                                            <asp:Panel ID="pnlChild4" runat="server" Width="100%">
                                                <div class="seperator">
                                                </div>
                                                <div>
                                                    <h3>
                                                        Child 4</h3>
                                                    <div class="h10">
                                                    </div>
                                                    <div class="w43per left">
                                                        <div id="divChildName4">
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Name:</div>
                                                            <div class="left pad_6t">
                                                                <asp:TextBox ID="txtChildName4" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                                <asp:RequiredFieldValidator ID="rfvChildName4" runat="server" CssClass="validationErrorControl"
                                                                    ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtChildName4"></asp:RequiredFieldValidator>
                                                                <asp:RegularExpressionValidator ID="revChildName4" runat="server" ControlToValidate="txtChildName4"
                                                                    ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                                    Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                            </div>
                                                        </div>
                                                        <div class="h10">
                                                        </div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Date of Birth:</div>
                                                            <div class="left">
                                                                <uc2:usrDate ID="ddlChildDOB4" ValidationGroup="proposal" runat="server"></uc2:usrDate>
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="w56per left">
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> NRIC Number:</div>
                                                            <div class="left">
                                                                <uc3:usrIdNumber ID="ddlChildIdNumber4" runat="server" ValidationGroup="proposal" />
                                                            </div>
                                                        </div>
                                                        <div class="h10">
                                                        </div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Gender:</div>
                                                            <div class="left">
                                                                <uc7:usrGender ID="ddlChildGender4" ValidationGroup="proposal" IsEnabled="true" ErrorMessage=""
                                                                    runat="server" />
                                                            </div>
                                                        </div>
                                                        <div class="clear">
                                                        </div>
                                                    </div>
                                                </div>
                                            </asp:Panel>
                                            <asp:Panel ID="pnlChild5" runat="server" Width="100%">
                                                <div class="seperator">
                                                </div>
                                                <div>
                                                    <h3>
                                                        Child 5</h3>
                                                    <div class="h10">
                                                    </div>
                                                    <div class="w43per left">
                                                        <div id="divChildName5">
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Name:</div>
                                                            <div class="left pad_6t">
                                                                <asp:TextBox ID="txtChildName5" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                                <asp:RequiredFieldValidator ID="rfvChildName5" runat="server" CssClass="validationErrorControl"
                                                                    ErrorMessage="" ValidationGroup="proposal" ControlToValidate="txtChildName5"></asp:RequiredFieldValidator>
                                                                <asp:RegularExpressionValidator ID="revChildName5" runat="server" ControlToValidate="txtChildName5"
                                                                    ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                                    Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                            </div>
                                                        </div>
                                                        <div class="h10">
                                                        </div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Date of Birth:</div>
                                                            <div class="left">
                                                                <uc2:usrDate ID="ddlChildDOB5" ValidationGroup="proposal" runat="server"></uc2:usrDate>
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="w56per left">
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> NRIC Number:</div>
                                                            <div class="left">
                                                                <uc3:usrIdNumber ID="ddlChildIdNumber5" runat="server" ValidationGroup="proposal" />
                                                            </div>
                                                        </div>
                                                        <div class="h10">
                                                        </div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Gender:</div>
                                                            <div class="left">
                                                                <uc7:usrGender ID="ddlChildGender5" ValidationGroup="proposal" IsEnabled="true" ErrorMessage=""
                                                                    runat="server" />
                                                            </div>
                                                        </div>
                                                        <div class="clear">
                                                        </div>
                                                    </div>
                                                </div>
                                            </asp:Panel>
                                        </div>
                                        <div class="bottom">
                                        </div>
                                    </div>
                                    <div class="seperator">
                                    </div>
                                </asp:Panel>

                                <script type="text/javascript">
                                    IncreaseProgress(45);
                                </script>

                                <div class="twoclmn" id="divOtherOnformationHeader">
                                    <div class="top">
                                    </div>
                                    <div class="body pad_15x" id="divOtherInfo">
                                        <h1>
                                            Datails on Occupation/Hobby/Insurance History</h1>
                                        <div class="seperator">
                                        </div>
                                        <div id="divOtherOnformation">
                                         <div id="divOccDuties" class="mar_10by">
                                                <div class="w650 left align_right pad_10xr">
                                                    <span class="red">*</span> 1. Are your occupation duties (please select)
                                                </div>
                                                <div class="w220 left pad_20_10x">
                                                    <span id="divAdministrative">
                                                        <asp:RadioButton onclick="ValOccDuties(false);CheckOccDutiesValidationCss();"
                                                            ID="rdoAdministrative" runat="server" GroupName="occduties" />
                                                        <asp:Label ID="lblAdministrative" class="pad_10xr" runat="server" Text="Administrative"></asp:Label>
                                                    </span><br /><span id="divSupervisory">
                                                        <asp:RadioButton onclick="ValOccDuties(false);CheckOccDutiesValidationCss();"
                                                            ID="rdoSupervisory" runat="server" GroupName="occduties" />
                                                        <asp:Label ID="lblSupervisory" runat="server" Text="Supervisory"></asp:Label>
                                                    </span><br />
                                                    <span id="divManual">
                                                        <asp:RadioButton onclick="ValOccDuties(false);CheckOccDutiesValidationCss();"
                                                            ID="rdoManual" runat="server" GroupName="occduties" />
                                                        <asp:Label ID="lblManual" runat="server" Text="Manual"></asp:Label>
                                                    </span>
                                                    <div style="display: none">
                                                        <asp:TextBox ID="txtOccDuties" runat="server"></asp:TextBox>
                                                    </div>
                                                    <asp:RequiredFieldValidator ID="rfvOccDuties" runat="server" CssClass="validationErrorControl"
                                                        Display="Dynamic" ErrorMessage="" ControlToValidate="txtOccDuties" ValidationGroup="proposal"
                                                        Text=""></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                            <div class="h7">
                                            </div>                                         
                                            <div id="divPerformManualstatus" class="mar_10by">
                                                <div class="w650 left align_right pad_10xr">
                                                    <span class="red">*</span> 2. Is any machinery other than hand tool used in relation
                                                    to your usual work?
                                                </div>
                                                <div class="w220 left pad_20_10x">
                                                    <span id="divYesPerformManual">
                                                        <asp:RadioButton onclick="ShowHideDiv('divPerformManual',true);ValPerformManual(true);CheckPerformManualValidationCss();"
                                                            ID="rdoYesPerformManual" runat="server" GroupName="performmanual" />
                                                        <asp:Label ID="lblYesPerformManual" class="pad_10xr" runat="server" Text="Yes"></asp:Label>
                                                    </span><span id="divNoPerformManual">
                                                        <asp:RadioButton onclick="ShowHideDiv('divPerformManual',false);ValPerformManual(false);CheckPerformManualValidationCss();"
                                                            ID="rdoNoPerformManual" runat="server" GroupName="performmanual" />
                                                        <asp:Label ID="lblNoPerformManual" runat="server" Text="No"></asp:Label>
                                                    </span>
                                                    <div style="display: none">
                                                        <asp:TextBox ID="txtPerformManual" runat="server"></asp:TextBox>
                                                    </div>
                                                    <asp:RequiredFieldValidator ID="rfvPerformManual" runat="server" CssClass="validationErrorControl"
                                                        Display="Dynamic" ErrorMessage="" ControlToValidate="txtPerformManual" ValidationGroup="proposal"
                                                        Text=""></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                            <div class="h7">
                                            </div>
                                            <div id="divPerformManual" style="display: ;" class="mar_10by">
                                                <div class="w650 left align_right pad_10xr">
                                                    <span class="red">*</span> Please specify
                                                </div>
                                                <div class="w220 left pad_20_10x">
                                                    <asp:TextBox ID="txtPerformManualReason" runat="server" Columns="25" MaxLength="100"
                                                        Rows="2" TextMode="MultiLine"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvPerformManualReason" ControlToValidate="txtPerformManualReason"
                                                        ErrorMessage="" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                </div>
                                                <div class="h7">
                                                </div>
                                            </div>
                                            <div id="divHazadousHobbystatus" class="mar_10by">
                                                <div class="w650 left align_right pad_10xr">
                                                    <span class="red">*</span> 3. Do you engage in any activites or hobbies normally
                                                    regarded as dangerous?
                                                </div>
                                                <div class="w220 left pad_20_10x">
                                                    <span id="divYesHazadousHobby">
                                                        <asp:RadioButton onclick="ShowHideDiv('divHazadousHobby',true);ValHazadousHobby(true);CheckHazadousHobbyValidationCss();"
                                                            ID="rdoYesHazadousHobby" runat="server" GroupName="hazadoushobby" />
                                                        <asp:Label ID="lblYesHazadousHobby" class="pad_10xr" runat="server" Text="Yes"></asp:Label>
                                                    </span><span id="divNoHazadousHobby">
                                                        <asp:RadioButton onclick="ShowHideDiv('divHazadousHobby',false);ValHazadousHobby(false);CheckHazadousHobbyValidationCss();"
                                                            ID="rdoNoHazadousHobby" runat="server" GroupName="hazadoushobby" />
                                                        <asp:Label ID="lblNoHazadousHobby" runat="server" Text="No"></asp:Label>
                                                    </span>
                                                    <div style="display: none">
                                                        <asp:TextBox ID="txtHazadousHobby" runat="server"></asp:TextBox>
                                                    </div>
                                                    <asp:RequiredFieldValidator ID="rfvHazadousHobby" runat="server" CssClass="validationErrorControl"
                                                        Display="Dynamic" ErrorMessage="" ControlToValidate="txtHazadousHobby" ValidationGroup="proposal"
                                                        Text=""></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                            <div class="h7">
                                            </div>
                                            <div id="divHazadousHobby" style="display: ;" class="mar_10by">
                                                <div class="w650 left align_right pad_10xr">
                                                    <span class="red">*</span> Please specify
                                                </div>
                                                <div class="w220 left pad_20_10x">
                                                    <asp:TextBox ID="txtHazadousHobbyReason" runat="server" Columns="25" MaxLength="100"
                                                        Rows="2" TextMode="MultiLine"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvHazadousHobbyReason" ControlToValidate="txtHazadousHobbyReason"
                                                        ErrorMessage="" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                </div>
                                                <div class="h7">
                                                </div>
                                            </div>
                                            <div id="divPhysicaldefectstatus" class="mar_10by">
                                                <div class="w650 left align_right pad_10xr">
                                                    <span class="red">*</span> 4. Do you have any physical defect or have suffered from
                                                    illness or disease or any injury during the past five (5) years?
                                                </div>
                                                <div class="w220 left pad_20_10x">
                                                    <span id="divYesPhysicaldefect">
                                                        <asp:RadioButton onclick="ShowHideDiv('divPhysicaldefect',true);ValPhysicaldefect(true);CheckPhysicaldefectValidationCss();"
                                                            ID="rdoYesPhysicaldefect" runat="server" GroupName="physicaldefect" />
                                                        <asp:Label ID="lblYesPhysicaldefect" class="pad_10xr" runat="server" Text="Yes"></asp:Label>
                                                    </span><span id="divNoPhysicaldefect">
                                                        <asp:RadioButton onclick="ShowHideDiv('divPhysicaldefect',false);ValPhysicaldefect(false);CheckPhysicaldefectValidationCss();"
                                                            ID="rdoNoPhysicaldefect" runat="server" GroupName="physicaldefect" />
                                                        <asp:Label ID="lblNoPhysicaldefect" runat="server" Text="No"></asp:Label>
                                                    </span>
                                                    <div style="display: none">
                                                        <asp:TextBox ID="txtPhysicaldefect" runat="server"></asp:TextBox>
                                                    </div>
                                                    <asp:RequiredFieldValidator ID="rfvPhysicaldefect" runat="server" CssClass="validationErrorControl"
                                                        Display="Dynamic" ErrorMessage="" ControlToValidate="txtPhysicaldefect" ValidationGroup="proposal"
                                                        Text=""></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                            <div class="h7">
                                            </div>
                                            <div id="divPhysicaldefect" style="display: ;" class="mar_10by">
                                                <div class="w650 left align_right pad_10xr">
                                                    <span class="red">*</span> Please specify
                                                </div>
                                                <div class="w220 left pad_20_10x">
                                                    <asp:TextBox ID="txtPhysicaldefectReason" runat="server" Columns="25" MaxLength="100"
                                                        Rows="2" TextMode="MultiLine"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvPhysicaldefectReason" ControlToValidate="txtPhysicaldefectReason"
                                                        ErrorMessage="" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                </div>
                                                <div class="h7">
                                                </div>
                                            </div>
                                            
                                            
                                            <div class="w650 left align_right pad_10xr">
                                                    <span class="red">*</span> 5. Has any insurer in connection with Accident, Sickness or Life insurance ever
                                                </div> <div class="h7">
                                            </div>  
                                            <div id="divDeclinedStatus" class="mar_10by">
                                                <div class="w650 left align_right pad_10xr">
                                                    <span class="red">*</span> (a) Deferred or declined a proposal, refused renewal or terminated an insurance?
                                                </div>
                                                <div class="w220 left pad_20_10x">
                                                    <span id="divYesDeclined">
                                                        <asp:RadioButton onclick="ShowHideDiv('divDeclinedIns',true);ValDeclinedIns(true);CheckDeclinedInsValidationCss();"
                                                            ID="rdoYesDeclined" runat="server" GroupName="declinedins" />
                                                        <asp:Label ID="lblYesDeclined" class="pad_10xr" runat="server" Text="Yes"></asp:Label>
                                                    </span><span id="divNoDeclined">
                                                        <asp:RadioButton onclick="ShowHideDiv('divDeclinedIns',false);ValDeclinedIns(false);CheckDeclinedInsValidationCss();"
                                                            ID="rdoNoDeclined" runat="server" GroupName="declinedins" />
                                                        <asp:Label ID="lblNoDeclined" runat="server" Text="No"></asp:Label>
                                                    </span>
                                                    <div style="display: none">
                                                        <asp:TextBox ID="txtDeclinedIns" runat="server"></asp:TextBox>
                                                    </div>
                                                    <asp:RequiredFieldValidator ID="rfvDeclinedIns" runat="server" CssClass="validationErrorControl"
                                                        Display="Dynamic" ErrorMessage="" ControlToValidate="txtDeclinedIns" ValidationGroup="proposal"
                                                        Text=""></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                            <div class="h7">
                                            </div>
                                            <div id="divDeclinedIns" style="display: ;" class="mar_10by">
                                                <div class="w650 left align_right pad_10xr">
                                                    <span class="red">*</span> Please Specify
                                                </div>
                                                <div class="w220 left pad_20_10x">
                                                    <asp:TextBox ID="txtDeclinedInsReason" runat="server" Columns="25" MaxLength="100"
                                                        Rows="2" TextMode="MultiLine"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvDeclinedInsReason" ControlToValidate="txtDeclinedInsReason"
                                                        ErrorMessage="" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                </div>
                                                <div class="h7">
                                                </div>
                                            </div>
                                            <div id="divInsuranceCancelledstatus" class="mar_10by">
                                                <div class="w650 left align_right pad_10xr">
                                                    <span class="red">*</span> (b) Required an increased premium or imposed special conditions?
                                                </div>
                                                <div class="w220 left pad_20_10x">
                                                    <span id="divYesInsuranceCancelled">
                                                        <asp:RadioButton onclick="ShowHideDiv('divInsuranceCancelled',true);ValInsuranceCancelled(true);CheckInsuranceCancelledValidationCss();ShowHideDiv('divPaymentMode',true);"
                                                            ID="rdoYesInsuranceCancelled" runat="server" GroupName="insurancecancelled" />
                                                        <asp:Label ID="lblYesInsuranceCancelled" class="pad_10xr" runat="server" Text="Yes"></asp:Label>
                                                    </span><span id="divNoInsuranceCancelled">
                                                        <asp:RadioButton onclick="ShowHideDiv('divInsuranceCancelled',false);ValInsuranceCancelled(false);CheckInsuranceCancelledValidationCss();ShowHideDiv('divPaymentMode',true);"
                                                            ID="rdoNoInsuranceCancelled" runat="server" GroupName="insurancecancelled" />
                                                        <asp:Label ID="lblNoInsuranceCancelled" runat="server" Text="No"></asp:Label>
                                                    </span>
                                                    <div style="display: none">
                                                        <asp:TextBox ID="txtInsuranceCancelled" runat="server"></asp:TextBox>
                                                    </div>
                                                    <asp:RequiredFieldValidator ID="rfvInsuranceCancelled" runat="server" CssClass="validationErrorControl"
                                                        Display="Dynamic" ErrorMessage="" ControlToValidate="txtInsuranceCancelled" ValidationGroup="proposal"
                                                        Text=""></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                            <div id="divInsuranceCancelled" style="display: " class="mar_10by">
                                                <div class="h7">
                                                </div>
                                                <div class="w650 left align_right pad_10xr">
                                                    <span class="red">*</span> Please Specify
                                                </div>
                                                <div class="w220 left pad_20_10x">
                                                    <asp:TextBox ID="txtInsuranceCancelledReason" runat="server" Columns="25" MaxLength="100"
                                                        Rows="2" TextMode="MultiLine"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvInsuranceCancelledReason" ControlToValidate="txtInsuranceCancelledReason"
                                                        ErrorMessage="" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                            <div id="divOtherInsurencestatus" class="mar_10by">
                                                <div class="w650 left align_right pad_10xr">
                                                    <span class="red">*</span> 6. Do you have any Accident, Medical or Life insurance with us or any other insurer(s)?
                                                </div>
                                                <div class="w220 left pad_20_10x">
                                                    <span id="divYesOtherInsurence">
                                                        <asp:RadioButton onclick="ShowHideDiv('divOtherInsurence',true);ValOtherInsurence(true);CheckOtherInsurenceValidationCss();"
                                                            ID="rdoYesOtherInsurence" runat="server" GroupName="otherinsurance" />
                                                        <asp:Label ID="lblYesOtherInsurence" class="pad_10xr" runat="server" Text="Yes"></asp:Label>
                                                    </span><span id="divNoOtherInsurence">
                                                        <asp:RadioButton onclick="ShowHideDiv('divOtherInsurence',false);ValOtherInsurence(false);CheckOtherInsurenceValidationCss();"
                                                            ID="rdoNoOtherInsurence" runat="server" GroupName="otherinsurance" />
                                                        <asp:Label ID="lblNoOtherInsurence" runat="server" Text="No"></asp:Label>
                                                    </span>
                                                    <div style="display: none">
                                                        <asp:TextBox ID="txtOI" runat="server"></asp:TextBox>
                                                    </div>
                                                    <asp:RequiredFieldValidator ID="rfvOI" runat="server" CssClass="validationErrorControl"
                                                        Display="Dynamic" ErrorMessage="" ControlToValidate="txtOI" ValidationGroup="proposal"
                                                        Text=""></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                            <div class="h7">
                                            </div>
                                            <div id="divOtherInsurence" style="display: ;">
                                                <div id="divInsuranceCompany" class="mar_10by">
                                                    <div class="w650 left align_right pad_10xr">
                                                        <span class="red">*</span> Current Insurance Co.
                                                    </div>
                                                    <div class="w220 left pad_20_10x">
                                                        <asp:DropDownList ID="ddlInsuranceCompany" Width="220px" runat="server">
                                                        </asp:DropDownList>
                                                        <asp:RequiredFieldValidator ID="rfvInsuranceCompany" ControlToValidate="ddlInsuranceCompany"
                                                            CssClass="validationErrorControl" runat="server" InitialValue="-1" ValidationGroup="proposal"
                                                            Text="" ErrorMessage=""></asp:RequiredFieldValidator>
                                                    </div>
                                                    <div class="h7">
                                                    </div>
                                                </div>
                                                <div id="divInsDetails" class="mar_10by">
                                                    <div class="w650 left align_right pad_10xr">
                                                        Details
                                                    </div>
                                                    <div class="w220 left pad_20_10x">
                                                        <asp:TextBox ID="txtInsDetails" runat="server" Columns="25" MaxLength="100" Rows="2"
                                                            TextMode="MultiLine" class="text"></asp:TextBox>
                                                    </div>
                                                    <div class="h7">
                                                    </div>
                                                </div>
                                            </div>
                                        </div>
                                        <div class="clear">
                                        </div>
                                    </div>
                                    <div class="bottom">
                                    </div>
                                </div>
                                <div class="seperator">
                                </div>

                                <script type="text/javascript">
                                    IncreaseProgress(65);
                                </script>

                                <div class="hilite" style="display: " id="divPaymentMode">
                                    <div class="top">
                                    </div>
                                    <div class="body_in pad_15x" id="divPaymentModeHeader">
                                        <h1>
                                            Payment Mode</h1>
                                        <div class="seperator">
                                        </div>
                                        I / We authorised <b>EQ Insurance Company Ltd</b> to debit the premium amount due
                                        in connection with above insurance policy.
                                        <div class="seperator">
                                        </div>
                                        <div>
                                            <div id="divNameoftheCard">
                                                <div class="w220 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Cardholder's Name:</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtNameoftheCard" MaxLength="50" runat="server" size="25"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvNameoftheCard" ControlToValidate="txtNameoftheCard"
                                                        ErrorMessage="" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                            <div class="h10">
                                            </div>
                                            <div id="divIssuingBank">
                                                <div class="w220 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Issuing Bank:</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtIssuingBank" MaxLength="50" runat="server" size="25"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvIssuingBank" ControlToValidate="txtIssuingBank"
                                                        ErrorMessage="" ValidationGroup="proposal" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                            <div class="h10">
                                            </div>
                                            <div id="divCardNo">
                                                <div class="w220 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Credit Card Number:</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtCardNo1" runat="server" MaxLength="4" size="8"></asp:TextBox>
                                                    <asp:TextBox ID="txtCardNo2" runat="server" MaxLength="4" size="8"></asp:TextBox>
                                                    <asp:TextBox ID="txtCardNo3" runat="server" MaxLength="4" size="8"></asp:TextBox>
                                                    <asp:TextBox ID="txtCardNo4" runat="server" MaxLength="4" size="8"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvCardNo1" ControlToValidate="txtCardNo1" ErrorMessage=""
                                                        ValidationGroup="proposal" CssClass="validationErrorControl" runat="server"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revCardNo1" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="proposal" ValidationExpression="[0-9]{4}" ControlToValidate="txtCardNo1"></asp:RegularExpressionValidator>
                                                    <asp:RequiredFieldValidator ID="rfvCardNo2" ControlToValidate="txtCardNo2" ErrorMessage=""
                                                        ValidationGroup="proposal" CssClass="validationErrorControl" runat="server"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revCardNo2" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="proposal" ValidationExpression="[0-9]{4}" ControlToValidate="txtCardNo2"></asp:RegularExpressionValidator>
                                                    <asp:RequiredFieldValidator ID="rfvCardNo3" ControlToValidate="txtCardNo3" ErrorMessage=""
                                                        ValidationGroup="proposal" CssClass="validationErrorControl" runat="server"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revCardNo3" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="proposal" ValidationExpression="[0-9]{4}" ControlToValidate="txtCardNo3"></asp:RegularExpressionValidator>
                                                    <asp:RequiredFieldValidator ID="rfvCardNo4" ControlToValidate="txtCardNo4" ErrorMessage=""
                                                        ValidationGroup="proposal" CssClass="validationErrorControl" runat="server"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revCardNo4" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="proposal" ValidationExpression="[0-9]{4}" ControlToValidate="txtCardNo4"></asp:RegularExpressionValidator>
                                                    <asp:CustomValidator CssClass="validationErrorControl" ControlToValidate="txtCreditCardValid"
                                                        ValidationGroup="proposal" ID="csvCreditCardValid" runat="server" ErrorMessage="Credit Card number not valid."
                                                        Text="" OnServerValidate="csvCreditCardValid_ServerValidate"></asp:CustomValidator>
                                                    <span style="display: none">
                                                        <asp:TextBox ID="txtCreditCardValid" Text="Valid" runat="server"></asp:TextBox>
                                                    </span>
                                                </div>
                                            </div>
                                            <div class="h10">
                                            </div>
                                            <div id="divCardExpiry">
                                                <div class="w220 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Card Expiry Date:</div>
                                                <div class="left">
                                                    <asp:DropDownList ID="ddlCardExpiryMonth" runat="server">
                                                        <asp:ListItem Selected="True" Value="-1">mm</asp:ListItem>
                                                        <asp:ListItem Value="01">01</asp:ListItem>
                                                        <asp:ListItem Value="02">02</asp:ListItem>
                                                        <asp:ListItem Value="03">03</asp:ListItem>
                                                        <asp:ListItem Value="04">04</asp:ListItem>
                                                        <asp:ListItem Value="05">05</asp:ListItem>
                                                        <asp:ListItem Value="06">06</asp:ListItem>
                                                        <asp:ListItem Value="07">07</asp:ListItem>
                                                        <asp:ListItem Value="08">08</asp:ListItem>
                                                        <asp:ListItem Value="09">09</asp:ListItem>
                                                        <asp:ListItem Value="10">10</asp:ListItem>
                                                        <asp:ListItem Value="11">11</asp:ListItem>
                                                        <asp:ListItem Value="12">12</asp:ListItem>
                                                    </asp:DropDownList>
                                                    <asp:DropDownList ID="ddlCardExpiryYear" runat="server">
                                                    </asp:DropDownList>
                                                    <asp:RequiredFieldValidator ID="rfvCardExpiryMonth" ControlToValidate="ddlCardExpiryMonth"
                                                        ErrorMessage="" ValidationGroup="proposal" InitialValue="-1" Text="" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                    <asp:RequiredFieldValidator ID="rfvCardExpiryYear" ControlToValidate="ddlCardExpiryYear"
                                                        ErrorMessage="" ValidationGroup="proposal" InitialValue="-1" Text="" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                    <asp:CustomValidator CssClass="validationErrorControl" ControlToValidate="txtCCExpiredValid"
                                                        ValidationGroup="proposal" ID="csvCCExpiredValid" runat="server" ErrorMessage="Credit Card expire not valid."
                                                        Text="" OnServerValidate="csvCCExpiredValid_ServerValidate"></asp:CustomValidator>
                                                    <span style="display: none">
                                                        <asp:TextBox ID="txtCCExpiredValid" Text="Valid" runat="server"></asp:TextBox>
                                                    </span>
                                                </div>
                                            </div>
                                            <div class="h10">
                                            </div>
                                            <div id="divCardType">
                                                <div class="w220 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Card Type:</div>
                                                <div class="left">
                                                    <span id="divVisa">
                                                        <asp:RadioButton onclick="ValCheckCardType();CheckCardTypeValidationCss();" ID="rdoVisa"
                                                            runat="server" GroupName="cardtype" />&nbsp;
                                                        <asp:Label ID="lblVisa" class="pad_10xr" runat="server" Text="VISA"></asp:Label>
                                                    </span><span id="divMasterCard">
                                                        <asp:RadioButton onclick="ValCheckCardType();CheckCardTypeValidationCss();" ID="rdoMasterCard"
                                                            runat="server" GroupName="cardtype" />&nbsp;
                                                        <asp:Label ID="lblMasterCard" runat="server" Text="MasterCard"></asp:Label>
                                                    </span>
                                                    <div style="display: none">
                                                        <asp:TextBox ID="txtCardType" runat="server"></asp:TextBox></div>
                                                    <asp:RequiredFieldValidator ID="rfvCardType" runat="server" CssClass="validationErrorControl"
                                                        Display="Dynamic" ErrorMessage="" ControlToValidate="txtCardType" ValidationGroup="proposal"
                                                        Text=""></asp:RequiredFieldValidator>
                                                    <div class="clear">
                                                    </div>
                                                    <em class="note">(Only VISA or Master Credit Card is acceptable for premium payment)</em>
                                                </div>
                                            </div>
                                        </div>
                                        <div class="seperator">
                                        </div>
                                        By submitting this proposal form, I am aware that any refund will be paid by cheque
                                        the Insured/Policyholder. <b>EQ Insurance Company Ltd</b> will consider all declared
                                        information as true and correct. This Credit Card payment is subject to the terms
                                        of the Credit Card Agreement.
                                    </div>
                                    <div class="bottom">
                                    </div>
                                </div>
                                <div class="seperator">
                                </div>
                                <div class="norm" id="divDeclaration">
                                    <div class="top">
                                    </div>
                                    <div class="body">
                                        <div class="pad_15x">
                                            <h1>
                                                Declaration</h1>
                                            <div class="seperator">
                                            </div>
                                            <p>
                                                I hereby declare and warrant the answers given above in every respect are true and
                                                correct and I have not withheld any information likely to affect acceptance of this
                                                Proposal, and agree that this Proposal Declaration shall be the basis of the Contract
                                                between the Company and myself, and I further agree to accept the Company’s Policy
                                                subject to the terms, exclusions and conditions to be expressed therein, endorsed
                                                thereon or attached thereto.<br />
                                            </p>
                                        </div>
                                    </div>
                                    <div class="bottom">
                                    </div>
                                </div>
                                <div class="seperator">
                                </div>
                                <div class="center align_center" id="divFormButtons">
                                    <asp:ImageButton ID="ibtSubmit" OnClientClick="LoadValidationErrorCss();CheckOptionValidationCss();"
                                        runat="server" ValidationGroup="proposal" ImageUrl="~/images/forms_proposal/button/submit.png"
                                        class="button" AlternateText="Submit Query" OnClick="ibtSubmit_Click" />
                                    <asp:Label ID="lblMessage" runat="server" ForeColor="Red"></asp:Label>
                                    <div class="note">
                                        <img src="/images/forms_proposal/icon/warning.png" width="21" height="18" alt="Note"
                                            style="vertical-align: middle; padding-bottom: 3px" />
                                        <strong>Note</strong>, by clicking on the SUBMIT button you agree to our Website's
                                        <a href="../../terms/terms.aspx" target="_blank">Terms &amp; Conditions</a>
                                    </div>
                                </div>
                            </div>
                        </div>
                        <div class="bottom">
                        </div>
                    </div>
                </div>
                <div class="seperator">
                </div>
            </div>
        </div>
    </div>
    <div id="footer">
        <div id="nav_bottom" class="pad_7t">
            <div class="left pad_8yr">
                <a href="/personal-accident/results.aspx" onclick="return confirm('Are you sure to go back?');">
                    <img src="/images/forms_proposal/button/back.png" alt="Back" /></a>
            </div>
            <div class="right pad_8yr">
                <a href="#" onclick="window.print()">
                    <img src="/images/forms_proposal/button/print.png" alt="Print" /></a>
            </div>
        </div>
    </div>

    <script type="text/javascript">
        IncreaseProgress(85);
    </script>

    <script type="text/javascript">

        function ShowHideDiv(divName, varOnOff) {
            if (varOnOff) {
                document.getElementById(divName).style.display = "";
            }
            else {
                document.getElementById(divName).style.display = "none";
            }
        }


        function CheckOptionValidationCss() {
            CheckOccDutiesValidationCss();
            CheckPerformManualValidationCss();
            CheckHazadousHobbyValidationCss();
            CheckPhysicaldefectValidationCss();
            CheckOtherInsurenceValidationCss();
            CheckDeclinedInsValidationCss();
            CheckInsuranceCancelledValidationCss();
            CheckCardTypeValidationCss();
        }

        function CheckValidationCss(divYes, divNo, ctrlText, valCtrl) {
            ShowValidationEffectOption(divYes, divNo, ctrlText, valCtrl);
            return true;
        }

        function CheckValidationCssThree(div1, div2, div3, ctrlText, valCtrl) {
            ShowValidationEffectOptionThree(div1, div2, div3, ctrlText, valCtrl);
            return true;
        }
        function CheckOccDutiesValidationCss() {
            CheckValidationCssThree('divAdministrative', 'divSupervisory', 'divManual', '<%=txtOccDuties.ClientID%>', '<%=rfvOccDuties.ClientID%>');
        }
        
        function CheckPerformManualValidationCss() {
            CheckValidationCss('divYesPerformManual', 'divNoPerformManual', '<%=txtPerformManual.ClientID%>', '<%=rfvPerformManual.ClientID%>');
        }

        function ValOccDuties(varOnOff) {
            var txtCtrl = document.getElementById("<%=txtOccDuties.ClientID%>");
            txtCtrl.value = "1";

            ValidatorEnable(document.getElementById('<%=rfvOccDuties.ClientID%>'), varOnOff);
        }
        
        function ValPerformManual(varOnOff) {
            var txtCtrl = document.getElementById("<%=txtPerformManual.ClientID%>");
            txtCtrl.value = "1";

            ValidatorEnable(document.getElementById('<%=rfvPerformManualReason.ClientID%>'), varOnOff);
        }

        function CheckHazadousHobbyValidationCss() {
            CheckValidationCss('divYesHazadousHobby', 'divNoHazadousHobby', '<%=txtHazadousHobby.ClientID%>', '<%=rfvHazadousHobby.ClientID%>');
        }

        function ValHazadousHobby(varOnOff) {
            var txtCtrl = document.getElementById("<%=txtHazadousHobby.ClientID%>");
            txtCtrl.value = "1";

            ValidatorEnable(document.getElementById('<%=rfvHazadousHobbyReason.ClientID%>'), varOnOff);
        }

        function CheckPhysicaldefectValidationCss() {
            CheckValidationCss('divYesPhysicaldefect', 'divNoPhysicaldefect', '<%=txtPhysicaldefect.ClientID%>', '<%=rfvPhysicaldefect.ClientID%>');
        }

        function ValPhysicaldefect(varOnOff) {
            var txtCtrl = document.getElementById("<%=txtPhysicaldefect.ClientID%>");
            txtCtrl.value = "1";

            ValidatorEnable(document.getElementById('<%=rfvPhysicaldefectReason.ClientID%>'), varOnOff);
        }

        function CheckOtherInsurenceValidationCss() {
            CheckValidationCss('divYesOtherInsurence', 'divNoOtherInsurence', '<%=txtOI.ClientID%>', '<%=rfvOI.ClientID%>');
        }

        function ValOtherInsurence(varOnOff) {
            var txtCtrl = document.getElementById("<%=txtOI.ClientID%>");
            txtCtrl.value = "1";

            ValidatorEnable(document.getElementById('<%=rfvInsuranceCompany.ClientID%>'), varOnOff);
        }

        function CheckDeclinedInsValidationCss() {
            CheckValidationCss('divYesDeclined', 'divNoDeclined', '<%=txtDeclinedIns.ClientID%>', '<%=rfvDeclinedIns.ClientID%>');
        }

        function ValDeclinedIns(varOnOff) {
            var txtCtrl = document.getElementById("<%=txtDeclinedIns.ClientID%>");
            txtCtrl.value = "1";

            ValidatorEnable(document.getElementById('<%=rfvDeclinedInsReason.ClientID%>'), varOnOff);
        }

        function CheckInsuranceCancelledValidationCss() {
            CheckValidationCss('divYesInsuranceCancelled', 'divNoInsuranceCancelled', '<%=txtInsuranceCancelled.ClientID%>', '<%=rfvInsuranceCancelled.ClientID%>');
        }

        function ValInsuranceCancelled(varOnOff) {
            var txtCtrl = document.getElementById("<%=txtInsuranceCancelled.ClientID%>");
            txtCtrl.value = "1";

            ValidatorEnable(document.getElementById('<%=rfvInsuranceCancelledReason.ClientID%>'), varOnOff);
        }

        function CheckCardTypeValidationCss() {
            CheckValidationCss('divVisa', 'divMasterCard', '<%=txtCardType.ClientID%>', '<%=rfvCardType.ClientID%>');
        }

        function ValCheckCardType(varOnOff) {
            var txtCtrl = document.getElementById("<%=txtCardType.ClientID%>");
            txtCtrl.value = "1";
        }


        //        function CheckSalGenderValid(source, arguments) {
        //            var ctrlsal = document.getElementById('<=ddlSalutation.ClientID>' + '_ddlSal');
        //            var ctrlgender = document.getElementById('<=ddlGender.ClientID>' + '_ddlGender');

        //            var sal = ctrlsal.value;
        //            var gender = ctrlgender.value;
        //            var result = true;
        //            if (gender == 'M') {
        //                if (sal == 'Ms' || sal == 'Miss' || sal == 'Mdm' || sal == 'Mrs') {
        //                    result = false;
        //                }
        //            }
        //            else if (gender == 'F') {
        //                if (sal == 'Mr') {
        //                    result = false;
        //                }
        //            }

        //            if (result == false) {
        //                ctrlsal.style.backgroundColor = '#fcc';
        //                ctrlsal.style.border = 'Solid 1px #f00';

        //                ctrlgender.style.backgroundColor = '#fcc';
        //                ctrlgender.style.border = 'Solid 1px #f00';
        //            }
        //            else {
        //                ctrlsal.style.backgroundColor = '';
        //                ctrlsal.style.border = '';

        //                ctrlgender.style.backgroundColor = '';
        //                ctrlgender.style.border = '';
        //            }
        //            arguments.IsValid = result;
        //        }

        //        var hookAVal = false;
        //        function HookSalValidation() {
        //            if (hookAVal == false) {
        //                prefix = "<=ddlSalutation.ClientID>";
        //                var ddlSal = prefix + "_ddlSal";
        //                prefix = "<=ddlGender.ClientID>";
        //                var ddlGender = prefix + "_ddlGender";
        //                var valCtrl = "<=csvSalGender.ClientID>";
        //                ValidatorHookupControlID(ddlSal, document.getElementById(valCtrl));
        //                ValidatorHookupControlID(ddlGender, document.getElementById(valCtrl));
        //                hookAVal = true;
        //            }
        //        }

        function Check2NRICValid(source, arguments) {
            var ddlnricpref = document.getElementById('<%=ddlIdNumber.ClientID%>' + '_ddlIdPrefix');
            var txtnricnum = document.getElementById('<%=ddlIdNumber.ClientID%>' + '_txtIdNumber');
            var ddlnricsuffix = document.getElementById('<%=ddlIdNumber.ClientID%>' + '_ddlIdPostfix');
            var applicantNRIC = ddlnricpref.value + txtnricnum.value + ddlnricsuffix.value;

            var ddlspousenricpref = document.getElementById('<%=ddlSpouseIdNumber.ClientID%>' + '_ddlIdPrefix');
            var txtspousenricnum = document.getElementById('<%=ddlSpouseIdNumber.ClientID%>' + '_txtIdNumber');
            var ddlspousenricsuffix = document.getElementById('<%=ddlSpouseIdNumber.ClientID%>' + '_ddlIdPostfix');
            var spouseNRIC = ddlspousenricpref.value + txtspousenricnum.value + ddlspousenricsuffix.value;

            var result = true;

            //alert(applicantNRIC + ' ' + spouseNRIC);

            if (applicantNRIC == spouseNRIC) {
                result = false;
            }
            else {
                result = true;
            }

            if (result == false) {
                ddlnricpref.style.backgroundColor = '#fcc';
                ddlnricpref.style.border = 'Solid 1px #f00';
                txtnricnum.style.backgroundColor = '#fcc';
                txtnricnum.style.border = 'Solid 1px #f00';
                ddlnricsuffix.style.backgroundColor = '#fcc';
                ddlnricsuffix.style.border = 'Solid 1px #f00';

                ddlspousenricpref.style.backgroundColor = '#fcc';
                ddlspousenricpref.style.border = 'Solid 1px #f00';
                txtspousenricnum.style.backgroundColor = '#fcc';
                txtspousenricnum.style.border = 'Solid 1px #f00';
                ddlspousenricsuffix.style.backgroundColor = '#fcc';
                ddlspousenricsuffix.style.border = 'Solid 1px #f00';
            }
            else {
                ddlnricpref.style.backgroundColor = '';
                ddlnricpref.style.border = '';
                txtnricnum.style.backgroundColor = '';
                txtnricnum.style.border = '';
                ddlnricsuffix.style.backgroundColor = '';
                ddlnricsuffix.style.border = '';

                ddlspousenricpref.style.backgroundColor = '';
                ddlspousenricpref.style.border = '';
                txtspousenricnum.style.backgroundColor = '';
                txtspousenricnum.style.border = '';
                ddlspousenricsuffix.style.backgroundColor = '';
                ddlspousenricsuffix.style.border = '';
            }
            arguments.IsValid = result;
        }

        var hookCompareVal = false;
        function HookCompareICValidation() {
            //            if (hookCompareVal == false) {
            //                prefix = "<%=ddlIdNumber.ClientID%>";
            //                var ddlnricpref = prefix + "_ddlIdPrefix";
            //                var txtnricnum = prefix + "_txtIdNumber";
            //                var ddlnricsuffix = prefix + "_ddlIdPostfix";
            //                
            //                prefix = "<%=ddlSpouseIdNumber.ClientID%>";
            //                var ddlspousenricpref = prefix + "_ddlIdPrefix";
            //                var txtspousenricnum = prefix + "_txtIdNumber";
            //                var ddlspousenricsuffix = prefix + "_ddlIdPostfix";
            //                var valCtrl = "<=csvNRIC.ClientID>";

            //                ValidatorHookupControlID(ddlnricpref, document.getElementById(valCtrl));
            //                ValidatorHookupControlID(txtnricnum, document.getElementById(valCtrl));
            //                ValidatorHookupControlID(ddlnricsuffix, document.getElementById(valCtrl));
            //                ValidatorHookupControlID(ddlspousenricpref, document.getElementById(valCtrl));
            //                ValidatorHookupControlID(txtspousenricnum, document.getElementById(valCtrl));
            //                ValidatorHookupControlID(ddlspousenricsuffix, document.getElementById(valCtrl));
            hookCompareVal = true;
            //            }
        }

        //    function EnableDisableValidations() 
        //    {
        //        var policytype = document.getElementById('<%=txtIsCover.ClientID%>').value;
        //        if (policytype == 'IND') 
        //        {
        //            ValidationSpouse(false);
        //            ValidationChild1(false);
        //            ValidationChild2(false);
        //            ValidationChild3(false);
        //            ValidationChild4(false);
        //            ValidationChild5(false);
        //        }
        //        else if (policytype == 'INDSP') 
        //        {
        //            ValidationSpouse(true);
        //            ValidationChild1(false);
        //            ValidationChild2(false);
        //            ValidationChild3(false);
        //            ValidationChild4(false);
        //            ValidationChild5(false);
        //        }
        //        else if (policytype == 'INDCHD') 
        //        {
        //            ValidationSpouse(false);
        //            EnableDisableChildValidations(); 
        //        }
        //        else 
        //        {
        //            ValidationSpouse(true);
        //            EnableDisableChildValidations(); 
        //        }
        //    }
        //    function EnableDisableChildValidations() 
        //    {
        //        var childcount = document.getElementById('<%=txtCHCount.ClientID%>').value;
        //        if (childcount == 1) {
        //            ValidationChild1(true);
        //            ValidationChild2(false);
        //            ValidationChild3(false);
        //            ValidationChild4(false);
        //            ValidationChild5(false);
        //        }
        //        else if (childcount == 2) {
        //            ValidationChild1(true);
        //            ValidationChild2(true);
        //            ValidationChild3(false);
        //            ValidationChild4(false);
        //            ValidationChild5(false);
        //        }
        //        else if (childcount == 3) {
        //            ValidationChild1(true);
        //            ValidationChild2(true);
        //            ValidationChild3(true);
        //            ValidationChild4(false);
        //            ValidationChild5(false);
        //        }
        //        else if (childcount == 4) {
        //            ValidationChild1(true);
        //            ValidationChild2(true);
        //            ValidationChild3(true);
        //            ValidationChild4(true);
        //            ValidationChild5(false);
        //        }
        //        else if (childcount == 5) {
        //            ValidationChild1(true);
        //            ValidationChild2(true);
        //            ValidationChild3(true);
        //            ValidationChild4(true);
        //            ValidationChild5(true);
        //        }
        //    }

        //    function ValidationSpouse(varOnOff) 
        //    {
        //        ValidatorEnable(document.getElementById('<%=rfvSpouseName.ClientID%>'), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=revSpouseName.ClientID%>'), varOnOff);
        //        ValidatorEnable(document.getElementById('<=ddlSpouseGender.ClientI%>' + "_rfvGender"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlSpouseIdNumber.ClientID%>' + "_csvIdPrefix"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlSpouseIdNumber.ClientID%>' + "_rfvIdNumber"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlSpouseIdNumber.ClientID%>' + "_revIdNumberLength"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlSpouseIdNumber.ClientID%>' + "_csvIdNumber"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlSpouseIdNumber.ClientID%>' + "_csvIdPostfix"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlNationality.ClientID%>' + "_rfvNationality"), varOnOff);
        //        ValidatorEnable(document.getElementById('<=ddlSpouseRelationship.ClientID>' + "_rfvRelationship"), varOnOff);
        //    }

        //    function ValidationChild1(varOnOff) {
        //        ValidatorEnable(document.getElementById('<%=rfvChildName1.ClientID%>'), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=revChildName1.ClientID%>'), varOnOff);
        //        IsEnableDateValidation('<%=ddlChildDOB1.ClientID%>', varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildGender1.ClientID%>' + "_rfvGender"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber1.ClientID%>' + "_csvIdPrefix"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber1.ClientID%>' + "_rfvIdNumber"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber1.ClientID%>' + "_revIdNumberLength"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber1.ClientID%>' + "_csvIdNumber"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber1.ClientID%>' + "_csvIdPostfix"), varOnOff);
        //        ValidatorEnable(document.getElementById('<=ddlChildNationality1.ClientID>' + "_rfvNationality"), varOnOff);
        //        ValidatorEnable(document.getElementById('<=ddlChildRelationship1.ClientID>' + "_rfvRelationship"), varOnOff);
        //    }

        //    function ValidationChild2(varOnOff) {
        //        ValidatorEnable(document.getElementById('<%=rfvChildName2.ClientID%>'), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=revChildName2.ClientID%>'), varOnOff);
        //        IsEnableDateValidation('<%=ddlChildDOB2.ClientID%>', varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildGender2.ClientID%>' + "_rfvGender"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber2.ClientID%>' + "_csvIdPrefix"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber2.ClientID%>' + "_rfvIdNumber"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber2.ClientID%>' + "_revIdNumberLength"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber2.ClientID%>' + "_csvIdNumber"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber2.ClientID%>' + "_csvIdPostfix"), varOnOff);
        //        ValidatorEnable(document.getElementById('<=ddlChildNationality2.ClientID>' + "_rfvNationality"), varOnOff);
        //        ValidatorEnable(document.getElementById('<=ddlChildRelationship2.ClientID>' + "_rfvRelationship"), varOnOff);
        //    }

        //    function ValidationChild3(varOnOff) {
        //        ValidatorEnable(document.getElementById('<%=rfvChildName3.ClientID%>'), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=revChildName3.ClientID%>'), varOnOff);
        //        IsEnableDateValidation('<%=ddlChildDOB3.ClientID%>', varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildGender3.ClientID%>' + "_rfvGender"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber3.ClientID%>' + "_csvIdPrefix"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber3.ClientID%>' + "_rfvIdNumber"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber3.ClientID%>' + "_revIdNumberLength"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber3.ClientID%>' + "_csvIdNumber"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber3.ClientID%>' + "_csvIdPostfix"), varOnOff);
        //        ValidatorEnable(document.getElementById('<=ddlChildNationality3.ClientID>' + "_rfvNationality"), varOnOff);
        //        ValidatorEnable(document.getElementById('<=ddlChildRelationship3.ClientID>' + "_rfvRelationship"), varOnOff);
        //    }

        //    function ValidationChild4(varOnOff) {
        //        ValidatorEnable(document.getElementById('<%=rfvChildName4.ClientID%>'), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=revChildName4.ClientID%>'), varOnOff);
        //        IsEnableDateValidation('<%=ddlChildDOB4.ClientID%>', varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildGender4.ClientID%>' + "_rfvGender"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber4.ClientID%>' + "_csvIdPrefix"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber4.ClientID%>' + "_rfvIdNumber"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber4.ClientID%>' + "_revIdNumberLength"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber4.ClientID%>' + "_csvIdNumber"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber4.ClientID%>' + "_csvIdPostfix"), varOnOff);
        //        ValidatorEnable(document.getElementById('<=ddlChildNationality4.ClientID>' + "_rfvNationality"), varOnOff);
        //        ValidatorEnable(document.getElementById('<=ddlChildRelationship4.ClientID>' + "_rfvRelationship"), varOnOff);
        //    }

        //    function ValidationChild5(varOnOff) {
        //        ValidatorEnable(document.getElementById('<%=rfvChildName5.ClientID%>'), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=revChildName5.ClientID%>'), varOnOff);
        //        IsEnableDateValidation('<%=ddlChildDOB5.ClientID%>', varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildGender5.ClientID%>' + "_rfvGender"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber5.ClientID%>' + "_csvIdPrefix"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber5.ClientID%>' + "_rfvIdNumber"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber5.ClientID%>' + "_revIdNumberLength"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber5.ClientID%>' + "_csvIdNumber"), varOnOff);
        //        ValidatorEnable(document.getElementById('<%=ddlChildIdNumber5.ClientID%>' + "_csvIdPostfix"), varOnOff);
        //        ValidatorEnable(document.getElementById('<=ddlChildNationality5.ClientID>' + "_rfvNationality"), varOnOff);
        //        ValidatorEnable(document.getElementById('<=ddlChildRelationship5.ClientID>' + "_rfvRelationship"), varOnOff);
        //    }

        function CheckAll() {
            //HookSalValidation();
            HookCompareICValidation();
        }
        function showhide(el) {

            el = document.getElementById(el);
            el.style.display = (el.style.display == "none") ? "block" : "none";

        }

        window.onload = function() {
            //showhide('divOtherOnformation');
            showhide('divPerformManual');
            showhide('divHazadousHobby');
            showhide('divPhysicaldefect');
            showhide('divOtherInsurence');
            showhide('divDeclinedIns');
            showhide('divInsuranceCancelled');
            //showhide('divPaymentMode');
            //EnableDisableValidations();


            if (document.getElementById('<%=rdoAdministrative.ClientID%>').checked == true) {
                ValPerformManual(true);
            }

            if (document.getElementById('<%=rdoYesPerformManual.ClientID%>').checked == true) {
                ShowHideDiv('divPerformManual', true);
                ValPerformManual(true);
            }
            else if (document.getElementById('<%=rdoNoPerformManual.ClientID%>').checked == true) {
                ShowHideDiv('divPerformManual', false);
                ValPerformManual(false);
            }
            else { ShowHideDiv('divPerformManual', false); }

            if (document.getElementById('<%=rdoYesHazadousHobby.ClientID%>').checked == true) {
                ShowHideDiv('divHazadousHobby', true);
                ValHazadousHobby(true);
            }
            else if (document.getElementById('<%=rdoNoHazadousHobby.ClientID%>').checked == true) {
                ShowHideDiv('divHazadousHobby', false);
                ValHazadousHobby(false);
            }
            else { ShowHideDiv('divHazadousHobby', false); }

            if (document.getElementById('<%=rdoYesPhysicaldefect.ClientID%>').checked == true) {
                ShowHideDiv('divPhysicaldefect', true);
                ValPhysicaldefect(true);
            }
            else if (document.getElementById('<%=rdoNoPhysicaldefect.ClientID%>').checked == true) {
                ShowHideDiv('divPhysicaldefect', false);
                ValPhysicaldefect(false);
            }
            else { ShowHideDiv('divPhysicaldefect', false); }

            if (document.getElementById('<%=rdoYesOtherInsurence.ClientID%>').checked == true) {
                ShowHideDiv('divOtherInsurence', true);
                ValOtherInsurence(true);
            }
            else if (document.getElementById('<%=rdoNoOtherInsurence.ClientID%>').checked == true) {
                ShowHideDiv('divOtherInsurence', false);
                ValOtherInsurence(false);
            }
            else { ShowHideDiv('divOtherInsurence', false); }

            if (document.getElementById('<%=rdoYesDeclined.ClientID%>').checked == true) {
                ShowHideDiv('divDeclinedIns', true);
                ValDeclinedIns(true);
            }
            else if (document.getElementById('<%=rdoNoDeclined.ClientID%>').checked == true) {
                ShowHideDiv('divDeclinedIns', false);
                ValDeclinedIns(false);
            }
            else { ShowHideDiv('divDeclinedIns', false); }

            if (document.getElementById('<%=rdoYesInsuranceCancelled.ClientID%>').checked == true) {
                ShowHideDiv('divInsuranceCancelled', true);
                ValInsuranceCancelled(true);
            }
            else if (document.getElementById('<%=rdoNoInsuranceCancelled.ClientID%>').checked == true) {
                ShowHideDiv('divInsuranceCancelled', false);
                ValInsuranceCancelled(false);
            }
            else { ShowHideDiv('divInsuranceCancelled', false); }

            if (document.getElementById('<%=txtCardType.ClientID%>').value == "1") {
                ShowHideDiv('divPaymentMode', true);
            }
            else { ShowHideDiv('divPaymentMode', true); }
        }


        function restrictToNumbers(e) {
            if ([e.keyCode || e.which] == 8 || [e.keyCode || e.which] == 37 || [e.keyCode || e.which] == 9 || [e.keyCode || e.which] == 39) //this is to allow backspace
                return true;

            if ([e.keyCode || e.which] < 48 || [e.keyCode || e.which] > 57)
                e.preventDefault ? e.preventDefault() : e.returnValue = false;
        }

        function requestByPostCode() {
            try {
                var _pcode = document.getElementById('<%=txtPostCode.ClientID%>').value;
                if (_pcode.length != 6) {
                    alert('Postal code length must be 6 numbers value.');
                    document.getElementById('<%=txtAddress.ClientID%>').value = '';
                    return false;
                }
                else {
                    requestData(_pcode);
                }
            }
            catch (e) {
                alert(e.toString());
            }
        }


        function set_data(json) {
            try {
                var srcTable = $("#divAddress").empty();
                var txtAddress = document.getElementById('<%=txtAddress.ClientID%>');
                if (json == null) {
                    $("<table><tr><td>No address found!</td></tr></table>").appendTo(srcTable);
                    alert("No address found!");
                    document.getElementById('<%=txtPostCode.ClientID%>').value = "";
                    txtAddress.value = "No Address found.";
                    return;
                }
                if (json.length == 0) {
                    $("<table><tr><td>No address found!</td></tr></table>").appendTo(srcTable);
                    alert("No address found!");
                    document.getElementById('<%=txtPostCode.ClientID%>').value = "";
                    txtAddress.value = "No Address found.";
                    return;
                }

                var tbl = $("<table width='50%'>");

                var tbody = $("<tbody>");
                var no = 1;
                for (var i = 0; i < json.length; i++) {
                    var trow = $("<tr>"), rec = json[i];
                    if (rec.t != null) {

                        var ctn = rec.t + "<br>" + rec.a;

                        //$("<td>").text(no).data("col", 1).appendTo(trow);
                        $("<td>").html(ctn).data("col", 2).appendTo(trow);
                        if (i == 0) {
                            txtAddress.value = rec.t + "\n" + rec.a;
                        }
                        else {
                            txtAddress.value += "\n\n" + rec.t + "\n" + rec.a;
                        }
                        no++;
                    }
                    trow.appendTo(tbody);
                }
                tbody.appendTo(tbl);
                //alert(srcTable);
                tbl.appendTo(srcTable);
            }
            catch (e) {
                alert(e.toString());
            }
        }

        function PostCodeChange() {
            document.getElementById('divAddress').innerHTML = "Your postcode changed.";
            document.getElementById('divAddress').style.display = 'none';
            document.getElementById('<%=txtAddress.ClientID%>').innerHTML = "Your postcode changed.\nGetting address from street directory...";
        }
    </script>

    <script type="text/javascript">
        IncreaseProgress(100);
        HideLoading();
    </script>

</asp:Content>
